How to correct potassium as per pH i.e. in acidosis and alkalosis in ICU; explained by Dr. P.K.Jain
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- Опубликовано: 5 окт 2024
- How to correct potassium as per pH in ABG i.e. in acidosis and alkalosis in ICU; explained by Dr. P.K.Jain
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The above video is trying to explain or answer the following queries:
How to correct potassium as per pH in ABG
How to correct potassium in acidosis and alkalosis
Correction factor for potassium in acidosis and alkalosis
Correction factor for potassium as per pH change in ABG
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Pearls like this are priceless. It drums it into your head. A Red flag is raised before you act. The years of immersion in the field. Thank you.
This is best one. Currently I am working in ICU in KSA. Your channel is a great help for me. Thank you so much sir
Awesome Sir ❤🇵🇰
Life savings tips with examples are best of all so far. I would like to suggest you to continue such shorts 5 to 10 min clips of common critical cases encountered in ICU are mistakes that must be highlighted in managing them.
Thank you
Great I really enjoyed your short lecture
We are all privileged to be bestowed with these extremely helpful lessons sir. They are of immense value.. please do continue them. Thank you!❤
😊 Thank you
How long after correcting for pH, with either Bicarbonate infusion (for acidosis) or fluids (for alkalosis), should we check/re-check the potassium levels?
Is it 30mins, 1hr, 2hr... etc... after starting bicarb or fluids? Or more? What is the guideline for this step?
Excellent question. Transcellular movement occurs in minutes so an hour should be good
@@chairman-ccef7876thank you so much Sir! Much appreciated!
I panicked when a pt was in hyperkalemia post blood transfusion, my consultant had my back since I was new in ICU! Thank God 🙏
It is a frightening situation as the hyperkalemia is real and due to RBC breakdown releasing the large intracellular potassium.
@@chairman-ccef7876 yes yes
We need more videos and learning like this sir ..... looking forward
Thank you sir
Thankyou sir 🙏 I am nurse this information is give us lot of knowledge 🙏 sir pls also include videos in mix Hindi language, for precise and clear understanding
Thank you Sir! Kindly make a snippet of IV magnesium correction. Thank you!
Wonderful recommendation. Will do that soon.😊
Well done sir
May Allah grant you long healthy life
Excellent information 👍
Very useful sir. Thank you so much for giving us such pearls
Thank you
It really worth,Thank you so much sir.
Wonderful explanation
Glad you liked it
Such a minute details but so crucial, very commonly ignored Thank u so much👍👍👍
Hi Sir, I am a critical care fellow from Pakistan. This pearl is very fascinating and new to me. I didn't find this thing even in Parillo (textbook of CCM) and Washington Manual. Can you please provide the reference of an article or book on this? Your youtube channel has always been helpful to me. Thank you.
It’s mentioned in almost every standard textbook . But for sake of reference, quoting uptodate link , www.uptodate.com/contents/potassium-balance-in-acid-base-disorders
Thank you, Sir.
Priceless piece of information Sir
Very valuable information indeed
Thank you so much sir, excellent sir
Thank you sir
Looking forward for more from you sir. It was very precise and very informative.
Glad you liked it
Amazing once again❤.
Though there alot of blunders is happening when we look around in our area's (in ICU).
it's shame when u do something to a patient without having a knowledge about it,
I wish to tagg my colleagues those who do arguments on something which they don't know, even though I have recommended this channel to them but they don't have time for it to learn and accept what is right.
To be honest i learned alot from this channel andhv been watching since beginning,
Brilliant ! Thank you Dr Jain it was helpful.
So good sir ....thank you so much ....
Thank you so much Sir🙏 please continue enlightening us with such priceless pearls
Thank you, we will try our best
Nice video sir , very knowledgeable. Please sir make a video on hypo/ hypernatremia
Thanks for the suggestions
Thanks a lot sir
Thanks for the wonderful teaching
Excellent information sir Thanks
Mind blowing concept......
Thank you for your innovative steps
We are with you 🙏🏼
Continue please
Thanks for the precious information sir, it would be much more helpful if u share the relevant litrature or links , so tat we can read more about it and can discus in hospitals with seniors
True. Will keep that in mind. Problem is that there is no single source. Its the amalgamation of 35 years of prolific reading and bedside experience.
Thank you for the knowledge!
Extremely crucial😊
Thank you for valuable information sir.
❤️ bows to you.
Really extra edge! Thanks to the team🎉
🎉 thanks Team, esteemed sir❤
Useful lesson
Glad to hear that
Thank you so much sir 🙏
Today's Learning.. ❤❤❤
Sir,would like to have many more such short videos. please give links for the same
Thank you Sir🙏
Excellent
Thanks for the video.Really learnt something important Can you kindly tell from where to study these facts.. Any book, article, guidelines
Thanks
Not many books that give such pearls though information drowned in a lot of other information. This site is an excellent source. 😊😊😊
What is low anion gap metabolic acidosis(LAGMA)? is there any term like this in the books?
Lovely video. Thanks
The uptodate article which was quoted mentions the correction is originally based on one study with less than 10 patients with a broad range and this number taken was the mean of that range.
Even if that be, the change in pH, for example acidosis, would cause extracellular shift of potassium, rising serum potassium levels.
So we are never really worried about the ' intracellular potassium'. The K+ outside (extracellular) is the one causing problems, which we correct routinely.
So if potassium is 7 and corrected is 5, wouldn't that give a false sense of security?
Or am I missing something entirely?
Thank you so much sir 👍👍👍
Brilliant 👏 👏. ECG also plays an important role in potassium management
Yes it does. 😊. But the importance is over emphasised in books.
yes ECG is important , because if ECG changes are coming, means its alarming and you need to act on it.
In my opinion, ECG changes only imply acute K elevation. Nothing more. So serious life threatening hyperkalemia (say in chronic Renal Disease, where the rise is gradual) may occur with NO ECG changes. So if No ECG changes, you have time to correct and I would consider say dialysis. When ECG changes are there, hyperkalemia is acute and medical management becomes an emergency.
Thanks sir
Very nice concept sir..
Thank u. And yeah, it’s very important
Good evening sir
Greetings from pune
Really very educational video and an eye opener,
Can the same principle be applied In case of DKA with T2DM with CKD stage 4-5, with metabolic acidosis , where deranged RFT, hyperkalaemia is very common occurrence. Keen to know the management of such cases
Thanks a lot sir❤
Sir, isn't it the hyperkalemia in acidosis cause arrhythmias? Aren't we be worried about this when the K+ is 6.2meq/l?
The Hyperkalemia in DKA is just a transcellelar shift that gets rapidly corrected once DKA treatment is started. In the example I gave, the corrected S.K was actually low. So its risky to try and reduce serum K when it is infact low. Does that clarify your doubt?
I have never heard this! Where can I read about it more? Do you have a link? Thank you so much for this.
Any standard ABG book .
Such a crucial detail must say!
Dr., just want to ask that we take the corrected K+ into account only for the ICU/ critical patients or for any such as non- critical inpatients and outpatients l? (Perhaps a very stupid question)
Will apply to anyone, but pH abnormalities more common when a person is critically ill
This applies for only metabolic acid base disorders or also for respiray sir???
Can someone explain in detail how to correct pottasium with PH ?
Beautiful
Woww
How come uptodate tells us to correct the hyperKalemia with insulin😢😢😢I am confused kindly elaborate
One doubt
In DKA when we plan to start Insulin Infusion we see the potassium before it so that potassium is the one that comes in ABG or the corrected one!
Considering same example if serum potassium is 8.5 n pH is 6.9, shouldn't we correct potassium level? Corrected potassium will be 5.
Definitely should be corrected. You answered the question yourself. The corrected K is high now. Justifies cautious correction.
Sir 0.1 pH down will increase potassium by 0.7 . Am I right
Then in example it will be 0.5*0.7=0.35
@cuteboy3dbax6year9 you are making a mistake. Your statement is right. Drop in pH by 0.1 increases the k by 0.7 mEw/L. Here it is 5 times 0.1, so increase of K will be 5 x 0.7 = 3.5 mEw/L.
Typo error. Please read mEq/L
Extremely low tolerance for error......a whole book in one sentence......
Sir, then if pt is posted for surgery and no time to correct alkalosis and hypokalemia, can we go ahead without fearing arrythmias??
In emergency u have to do your best with ongoing corrections … in elective cases , u need to optimise as much as u can .
🙏🤝
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Kindly share reference please
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Pakka
कृतज्ञ हुआ
Books cannot beat experience
Well said
So true
thank u Sir
Welcome
Thank you so much sir
Thank you so much sir
Most welcome